ASA 102 Registration Form

ASA 102 Class Registration

Use this form to sign up, pick a class date, and pay for our ASA 102 Sailing Class.

Name*

FirstLast

Address*

Street AddressAddress Line 2CityStateZIP Code

Email*

Phone*

AYC Member?*

Yes

No

AYC Member Number*

How did you hear about Austin Yacht Club's ASA 102 class?

Please Select ONE of the Class Dates Below*

Nov. 24, 2018

Dec. 29,2018

Jan. 26, 2019

Feb. 23, 2019

March 23, 2019

* Please select the date you would like to do your training.

AYC Member Registration

Price:$99.00

Member fee = $99.00

Non-Member Registration

Price:$99.00

YOUR REGISTRATION IS NOT COMPLETE UNLESS YOU PAY IN FULL USING PAYPAL ON THE NEXT PAGE (after you click 'SUBMIT').

AYC Member Payment Options:*

AYC Member Charge

PayPal

Comments

If you have any questions or comments regarding the class enter here.

IN CONSIDERATION of being given the opportunity to participate in the Austin Yacht Club (AYC) American Sailing Association program, I, on behalf of myself, my personal representatives, heirs, and next of kin: 1. ACKNOWLEDGE, agree, and represent that I understand the nature of Boating Activities, both on water and land based, and that I am qualified, in good health, and in proper physical condition to participate in such Activity; 2. FULLY UNDERSTAND that: (a) BOATING ACTIVITIES INVOLVE RISKS AND DANGERS of serious bodily injury, including permanent disability, paralysis and death ("Risks"); (b) these risks and dangers may be caused by my own actions, or inactions, the actions or inactions of others participating in the Activity, the condition in which the Activity takes place, or the negligence of the Releasees named below; (c) there may be other risks and social and economic losses either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation in the Activity; 3. AGREE AND WARRANT that I will examine and inspect each Activity in which I take part as a visitor to AYC and that, if I observe any condition which I consider to be unacceptably hazardous or dangerous, I will notify the proper authority in charge of the Activity and will refuse to take part in the Activity until the condition has been corrected to my satisfaction; 4. HEREBY RELEASE, discharge, and covenant not to sue the Austin Yacht Club, their administrators, directors, agents, officers, volunteers, and employees, other participants, from all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the Releasees or otherwise, including negligent rescue operations; and further agree that if, despite this release and waiver of liability, assumption of risk, and indemnity agreement, I, or anyone on my behalf, makes a claim against any of these Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS each of the Releasees from any litigation expenses, attorney fees, loss, liability damage, or cost which any may incur as the result of such claim.*